First Lutheran Church, Algona IA - VBS Child Registration

Parent / Guardian Information

Contact

✕

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Add another person

Emergency Contacts (not listed above)

Who is authorized to pick up your child(ren) from VBS?

How many children are you registering today?

Name of Child 1

Date of Birth

Gender

Grade in Fall 2023

T-Shirt Size

Does the child have any allergies?
Yes
No

Please list all food and environmental allergies:

Are there any medical concerns we should be aware of?
Yes
No

Please include all medical concerns:

Name of Child 2

Date of Birth for Child 2

Gender of Child 2

Grade in Fall 2023 for Child 2

T-Shirt Size of Child 2

Does Child 2 have any allergies?
Yes
No

Please list all food and environmental allergies for Child 2:

Are there any medical concerns we should be aware of for Child 2?
Yes
No

Please include all medical concerns for Child 2:

Name of Child 3

Date of Birth for Child 3

Gender of Child 3

Grade in Fall 2023 for Child 3

T-Shirt Size of Child 3

Does Child 3 have any allergies?
Yes
No

Please list all food and environmental allergies for Child 3:

Are there any medical concerns we should be aware of for Child 3?
Yes
No

Please include all medical concerns for Child 3:

Name of Child 4

Date of Birth for Child 4

Gender of Child 4

Grade in Fall 2023 for Child 4

T-Shirt Size of Child 4

Does Child 4 have any allergies?
Yes
No

Please list all food and environmental allergies for Child 4 :

Are there any medical concerns we should be aware of for Child 4?
Yes
No

Please include all medical concerns for Child 4:

I give permission for photographs or videos of my child(ren) taken as part of First Lutheran VBS 2023, to be used now or in the future for the purpose of internal and external communications, including advertising and marketing as well as posted on Social Medical account(s) including Facebook, Instagram, and the website. I understand I can withdraw this consent at any time by advising the First Lutheran office in writing.
Agree
Disagree, do not use my child's photos or videos

In the event I cannot be reached, I hereby give permission for First Lutheran Church VBS to secure proper and necessary treatment / medical attention for my child(red) as named on this form.
I agree
I disagree, do not seek emergency medical treatment without my concent.

Signature

Vacation Bible School 2023
Child Registration Form

Parent / Guardian Information

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Vacation Bible School 2023 Child Registration Form

Parent / Guardian Information

About

What We Believe

Our Story

Leadership

Sunday Mornings

Contact Info

Prayer

Follow Us

Vacation Bible School 2023
Child Registration Form